McMan's Depression and Bipolar Web

ANGER

Knowing how to keep cool can help you stay calm.

A PSYCHOLOGY TODAY poll from 1983 asked: "If you could secretly push a button and thereby eliminate any person with no repercussions to yourself, would you press that button?"

Yes, said 69 percent of the males and 56 percent of the women, representing tens of millions of would-be dead bosses, co-workers, spouses and lovers and ex’s, family members, neighbors, politicians, telemarketers, movie stars, news reporters with bad wigs, reality game show contestants, and lawyers who appear on Geraldo.

Another 1980s survey asked college students if the US could wipe out the Soviet Union with no threat of retaliation should the government do it? Fifteen percent thought this would be a good idea.

What We Know About Anger

This is pure anger talking, as potentially as deadly as cyanide on a personal level, more powerful than a nuclear weapon on a collective level. Sooner or later everyone must learn to deal with their anger or face the consequences. For people with mood disorders the stakes are even higher, as anger is to an episode what a match is to a keg of gunpowder. The process also works in reverse, as our population, including our loved ones, generally have a lot to be angry about.

Anger is "an emotional state that varies in intensity from mild irritation to intense fury and rage," says Charles Spielberger PhD in a brochure published by the American Psychological Association.

People prone to anger tend to experience events as more stressful than others. In response to stress, adrenaline and cortisol are pumped into the system, priming the body for flight or fight, appropriate for caveman daily living and the occasional modern contingency, but not for most situations we find ourselves in. Anger is an adaptive response to threat, arousing powerful aggressive feelings and behaviors. Escalating stress and anger effectively stoke one another. When the process rages out of control, the excess adrenaline and cortisol set off a cascade of destructive cellular reactions that result in the brain being unable to cope.

Depression, goes the old saying, is anger turned inward. Various studies have found anger attacks to be common in 40 to 60 percent of those with unipolar and bipolar depression. The rate is about the same for bipolar mixed states. Surprisingly, no studies appear on PubMed documenting anger in mania. The DSM lists as a separate illness "intermittent explosive disorder," which Susan McElroy MD of the University of Cincinnati thinks may be related to bipolar disorder.

Equally surprising, the DSM fails to list anger as a symptom for either depression or mania, perhaps because the trait is endemic in the general population, as well, and so is regarded as normal (which is a very scary thought). Make no mistake - any state of mind that can disrupt your work and social relationships and potentially freeze you out of any life worth living should not be regarded as normal. And because our illness amplifies feelings and makes us lose rational control, we need to regard ourselves as skating on very thin ice.

Problem solving (not every problem has a solution, but one can work on a plan to cope).

Better communication (think before you speak and listen before you respond defensively).

Using humor.

Changing your environment (such as quiet time breaks).

Buddhist mindfulness techniques advocate non-attachment to angry thoughts that arise. Basically, one is asked to simply observe one’s anger with disinterest and focus on breathing. In a best case scenario, the anger will dissipate. Thoughts only acquire force, say Buddhist teachers, when we attach ourselves to these thoughts. Since our inflated egos are our own worst enemies, it pays to think of ourselves as ego-less Buddhas full of infinite compassion, even for the people we attribute our anger to.

Modern psychology is heavily derivative of Buddhist mindfulness. Though we may lack an adept's capacity to mindfully dissolve our worst thoughts, we can buy ourselves a few precious seconds before we do something irretrievably stupid. In essence, we can recognize our destructive thoughts as they occur, and then work with them.

Buddhism also teaches loving kindness meditation, part of which involves working to replace angry thoughts toward an individual with Christ-like thoughts of infinite compassion. Practice may hardly make perfect, but functional imperfection is something to shoot for.

Buddhist mindfulness techniques advocate non-attachment to angry thoughts that arise. Basically, one is asked to simply observe one’s anger with disinterest and focus on breathing. In a best case scenario, the anger will dissipate. Thoughts only acquire force, say Buddhist teachers, when we attach ourselves to these thoughts. Since our inflated egos are our own worst enemies, it pays to think of ourselves as ego-less Buddhas full of infinite compassion, even for the people we attribute our anger to.

Modern psychology is heavily derivative of Buddhist mindfulness. Though we may lack an adept's capacity to mindfully dissolve our worst thoughts, we can buy ourselves a few precious seconds before we do something irretrievably stupid. In essence, we can recognize our destructive thoughts as they occur, and then work with them.

Venting vs Suppressing

Psychologists point out that there are distinctions between "exploders" and "swallowers," between those who let ‘er rip and those who hold it in. Healthy venting can provide a constructive release for anger, but may also add fuel to the fire. Therapists sometimes encourage clients to act out their anger as a form of catharsis, but other experts feel this may only whet the appetite.

On the other side of the coin, there is a danger in bottling your anger, as it can turn inward on yourself, resulting in hypertension, high blood pressure, and depression. Suppressed anger can also wind up surfacing in unexpected situations - often directed at innocent bystanders - a phenomenon known as displacement. Finally, unexpressed anger can result in passive-aggressive behavior, which involves getting back at people indirectly instead of confronting them head-on.

In an episode form the sixties TV series, "Car 54, Where Are You?" (which happened to be William Faulkner's favorite show, I kid you not), Rocky Graziano plays Antoinne, a sweet-natured hair-dresser who loves going to the park to feed the birds. In the amateur boxing ring, however, he is like Mike Tyson on steroids. His wife recruits Toody and Muldoon to get him to quit his dangerous hobby, and they convince Sugar Ray Robinson to disguise himself as an old man and go a few rounds with Antoinne. Thoroughly humiliated from his whipping at the hands of a senior citizen, Antoinne quits boxing, but now has no release for his aggressions. He begins insulting his customers, starts making life miserable for his wife, and storms out the door with a rifle, announcing he is going to the park to shoot the birds. All ends well when he returns to the ring.

Final Word

Anger is that pet tiger you take out for a walk. The beast needs occasional air and exercise, but how successful you are at releasing it from its cage depends on your well-honed skill and judgment. If you have any doubt about whether you should sound off or bite your lip, ask yourself if your would-be response is proportionate to your hurt. If you’re thinking of mowing down your boss with an Uzi, for instance, it might be better to take a couple of deep breaths and resolve to take up your grievance at a later time.

People who choose the Uzi option may want to consider courses in anger management or seek a therapist. Those who find themselves always putting a lid on it may also find it useful to seek a therapist.

Finally, it pays not to dwell upon THEM vs US. It is way too easy to get angry at people we perceive as different from ourselves. The news media play on our worst fears, and unscrupulous politicians, religious figures, and talk show hosts are quick to find convenient scapegoats to channel public resentment. Because of our illness, we are the ones who find ourselves on the THEM receiving end, subject to opprobrium and ridicule and humiliation. We know from personal experience how destructive THEM vs US thinking truly is. Other populations have felt its terrible force in full measure. We need not contribute to this form of madness.